PDF(Pubmed)
Abstract：
BACKGROUND: Antimicrobial resistance, exacerbated by antibiotic misuse, poses a global threat. Though delayed antibiotic prescribing (DAP) can mitigate antibiotic overuse, its adoption in developing nations, such as China, is limited. This study probed barriers and facilitators to DAP in Xinjiang, characterized by extensive rural landscapes and primary care institutions (PCIs).
METHODS: Adopting a qualitative methodology, we conducted key informant interviews with thirty participants across six county hospitals in Xinjiang using VooV Meeting. Employing a two-stage sampling method targeting economically diverse areas, our interviews spanned physicians, pharmacists, patients, and caregivers. We organized the data according to the Theoretical Domains Framework (TDF) and the Behavior Change Wheel (BCW), spotlighting behavioral and policy elements impacting DAP.
RESULTS: Our research included thirty interviewees. Twelve physicians contemplated delayed prescriptions, while five adult patients and six caregivers encountered recommendations for delayed antibiotic prescriptions. Six patients sought pharmacists\' advice on antibiotic necessity. Prominent TDF domains were memory, attention, and beliefs about consequences. Critical intervention functions included education and environmental restructuring, while vital policy categories encompassed communication/marketing and guidelines.
CONCLUSIONS: Countering antibiotic misuse and resistance in China necessitates overcoming barriers through strategic resource distribution, comprehensive education, rigorous training, and consistent monitoring, thereby promoting DAP adoption. The adoption of DAP in rural healthcare settings in China has the potential to significantly reduce antibiotic misuse, thereby mitigating the global threat of antimicrobial resistance.
METHODS: Adopting a qualitative methodology, we conducted key informant interviews with thirty participants across six county hospitals in Xinjiang using VooV Meeting. Employing a two-stage sampling method targeting economically diverse areas, our interviews spanned physicians, pharmacists, patients, and caregivers. We organized the data according to the Theoretical Domains Framework (TDF) and the Behavior Change Wheel (BCW), spotlighting behavioral and policy elements impacting DAP.
RESULTS: Our research included thirty interviewees. Twelve physicians contemplated delayed prescriptions, while five adult patients and six caregivers encountered recommendations for delayed antibiotic prescriptions. Six patients sought pharmacists\' advice on antibiotic necessity. Prominent TDF domains were memory, attention, and beliefs about consequences. Critical intervention functions included education and environmental restructuring, while vital policy categories encompassed communication/marketing and guidelines.
CONCLUSIONS: Countering antibiotic misuse and resistance in China necessitates overcoming barriers through strategic resource distribution, comprehensive education, rigorous training, and consistent monitoring, thereby promoting DAP adoption. The adoption of DAP in rural healthcare settings in China has the potential to significantly reduce antibiotic misuse, thereby mitigating the global threat of antimicrobial resistance.
摘要：
背景：抗菌素耐药性，抗生素滥用加剧了，构成全球威胁。虽然延迟抗生素处方（DAP）可以减轻抗生素的过度使用，它在发展中国家采用，比如中国,是有限的。本研究探讨了新疆DAP的障碍和促进因素，其特点是广泛的农村景观和初级保健机构(PCI)。
方法：采用定性方法，我们使用VooVMeeting对新疆6家县级医院的30名参与者进行了关键线人访谈。采用针对经济不同地区的两阶段抽样方法，我们的采访跨越了医生，药剂师,病人,和照顾者。我们根据理论域框架(TDF)和行为变化轮(BCW)组织数据，突出影响DAP的行为和政策要素。
结果：我们的研究包括30位受访者。十二名医生考虑延迟处方，而5名成年患者和6名照顾者遇到了延迟抗生素处方的建议。六名患者寻求药剂师关于抗生素必要性的建议。突出的TDF域是记忆，注意,以及对后果的信念。关键的干预职能包括教育和环境重组，而重要的政策类别包括沟通/营销和指导方针。
结论：在中国应对抗生素滥用和耐药性需要通过战略资源分配来克服障碍，全面教育,严格的训练,和一致的监测，从而促进DAP的采用。在中国农村医疗机构中采用DAP有可能显着减少抗生素的滥用，从而减轻全球抗生素耐药性的威胁。
方法：采用定性方法，我们使用VooVMeeting对新疆6家县级医院的30名参与者进行了关键线人访谈。采用针对经济不同地区的两阶段抽样方法，我们的采访跨越了医生，药剂师,病人,和照顾者。我们根据理论域框架(TDF)和行为变化轮(BCW)组织数据，突出影响DAP的行为和政策要素。
结果：我们的研究包括30位受访者。十二名医生考虑延迟处方，而5名成年患者和6名照顾者遇到了延迟抗生素处方的建议。六名患者寻求药剂师关于抗生素必要性的建议。突出的TDF域是记忆，注意,以及对后果的信念。关键的干预职能包括教育和环境重组，而重要的政策类别包括沟通/营销和指导方针。
结论：在中国应对抗生素滥用和耐药性需要通过战略资源分配来克服障碍，全面教育,严格的训练,和一致的监测，从而促进DAP的采用。在中国农村医疗机构中采用DAP有可能显着减少抗生素的滥用，从而减轻全球抗生素耐药性的威胁。
